Warning: fopen(/home/virtual/enm-kes/journal/upload/ip_log/ip_log_2024-07.txt): failed to open stream: Permission denied in /home/virtual/lib/view_data.php on line 100 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 101 Obstructive Sleep Apnea Screening and Effects of Surgery in Acromegaly: A Prospective Study
Skip Navigation
Skip to contents

Endocrinol Metab : Endocrinology and Metabolism

clarivate
OPEN ACCESS
SEARCH
Search

Articles

Page Path
HOME > Endocrinol Metab > Ahead-of print > Article
Original Article Obstructive Sleep Apnea Screening and Effects of Surgery in Acromegaly: A Prospective Study
Jaeyoung Cho1,2*orcid , Jung Hee Kim2,3*orcid , Yong Hwy Kim3,4, Jinwoo Lee1,2orcid

DOI: https://doi.org/10.3803/EnM.2024.1933 [Epub ahead of print]
Published online: June 26, 2024
  • 346 Views
  • 12 Download
  • 0 Crossref
  • 0 Scopus
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
3Pituitary Center, Seoul National University Hospital, Seoul, Korea
4Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
Corresponding author:  Jinwoo Lee, Tel: +82-2-2072-7593, Fax: +82-2-2072-7246, 
Email: realrain7@gmail.com
*These authors contributed equally to this work.
Received: 5 January 2024   • Revised: 22 March 2024   • Accepted: 5 April 2024
contributed equally to this study as co-first authors.

Background
To identify a screening tool for obstructive sleep apnea (OSA) and evaluate the effects of endoscopic transsphenoidal surgery on improving OSA in patients with acromegaly.
Methods
We prospectively enrolled adults with acromegaly scheduled for endoscopic transsphenoidal surgery. All measurements were conducted when participants were admitted for a baseline work-up for acromegaly before surgery and surveillance approximately 3 to 6 months after surgery. Respiratory event index (REI) was used as a surrogate for apnea-hypopnea index (Trial Registration: NCT03526016).
Results
Of the 35 patients with acromegaly (median age, 47 years; 40% men; median body mass index, 24.4 kg/m2), 24 (68.6%) had OSA (REI ≥5/hour), 15 (42.9%) had moderate-to-severe OSA (REI ≥15/hour). At baseline, serum insulin-like growth factor 1 (IGF-1) levels were positively correlated with the REI (ρ=0.53, P=0.001). The sensitivity and negative predictive value of a Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, age, Neck circumference, and Gender (STOP-Bang) score ≥ 3 were 93.3% and 87.5%, respectively, detecting moderate-to-severe OSA. Biochemical acromegaly remission was achieved in 32 (91.4%) patients. The median difference in the REI was –9.5/hour (95% confidence interval, –13.3 to –5.3). Half of the 24 patients diagnosed with OSA preoperatively had REI <5/hour postoperatively. In a linear mixed-effects model, changes in the REI across surgery were related to changes in IGF-1 levels.
Conclusion
The STOP-Bang questionnaire is a reliable tool for OSA among patients with acromegaly. Improvement in OSA severity after surgery is related to decreased IGF-1 levels.

Related articles

Endocrinol Metab : Endocrinology and Metabolism